Pathological malabsorption of the digestive tract

2021-01-27 12:00 AM

Diagnosed by endoscopy and biopsy of duodenal mucosa, small bowel flow scan is mainly used to detect complications such as ulcers or lymphoma.

Outline

Malabsorption syndrome represents a partial or complete impairment of the digestive tract's absorption function. Diagnosing malabsorption syndrome is usually not difficult, but diagnosing the cause is often complex.

Clinical symptoms

Slim, though still delicious.

Going to flow.

Distention.

Low blood pressure: due to lack of water and malnutrition.

Clinical and biological symptoms of vitamin deficiency: as a result of prolonged malabsorption.

Anaemia: due to malabsorption of iron, B 12 and folic acid.

Bleeding.

Tetanise: Do a lack of calcium.

Muscle weakness: due to malnutrition, hypokalaemia.

Night blindness: Do Vitamin A deficiency.

Peripheral polyneuritis: due to lack of vitamins B12 and B1.

Subclinical

Indirect signs of fertility:

Anaemia, serum Fe decreased, folate and vitamin B12 decreased.

Reduced blood calcium.

The prothrombin rate decreased.

Albumin blood reduction.

Reduced blood cholesterol.

The absorption function probe.

Quantitative fat in stool:> 6 g / 24 hours.

D-Xylose test: <250 mg / l at 2 hours.

Schilling test with internal factor <10%.

Main reasons

Table: Common causes of malabsorption syndrome:

Reason

Diagnose

Before intestinal cells (lumen) Chronic pancreatitis, pancreatic cancer.

Clogging, secreting.

Increased intestinal bacteria.

The untreated abdominal film, ultrasound or tomography.

Liver test, ultrasound.

Breathlessness, intestinal circulation scan.

Enteric cells.

Coeliac disease.

Lack of immunoglobulin.

Giardia infection.

 Whipple disease.

Intestinal injury: Crohn's disease, bowel resection, intestinal fistula, lymphoma ...

Duodenal biopsy.

Quantification of Ig.

Testing for parasites.

History, medical history.

Intestinal circulation, endoscopy.

After intestinal cells.

Primary or secondary dilatation.

Morphology, biopsy, alpha-1-antitrypsin clearance test.

Coeliac disease

It is the most common cause of malabsorption syndrome in adults and children. The disease is caused by an intolerance of the gastrointestinal tract mucosa to protein fragments in the gluten of grains, especially gliadin.

It is manifested by chronic flow, syndrome of lack of nutrients (anaemia, osteoporosis, bone pain ...), accompanied by some external manifestations such as arthralgia, dermatitis, some other autoimmune manifestations.

Diagnosed by endoscopy and biopsy of duodenal mucosa, small bowel flow scan is mainly used to detect complications such as ulcers or lymphoma.

Treatment is mainly with gluten-free secretions.

Whipple disease

Considered to be caused by a Tropheryma Whipple type infection.

Symptoms combine a malabsorption syndrome with symptoms beyond the gastrointestinal tract such as polyarthritis, fever, neurological symptoms.

Diagnosis is based on biopsy of duodenum-jejunum. The disease usually responds to antibiotic treatment.

Increased intestinal bacteria

The easing factor is usually intestinal anatomical abnormalities (blind mumps, focal narrowing or colonic diverticula) or functional abnormalities (scleroderma, chronic obstructive bowelism, no hydrochloric acid).

Diagnosis is based on hypoglycaemia.

Diarrheal usually decreases with antibiotic treatment

Exocrine failure

Usually caused by chronic pancreatitis, and more rarely pancreatic cancer, removal of the pancreas.